Association Between Cardiovascular Risk Factors and Hearing Loss, Including Sudden Sensorineural Hearing Loss: An Umbrella Review of Systematic Reviews and Meta-Analyses

Hearing loss is among the most common chronic diseases worldwide, affecting approximately 466 million people. Increasing evidence suggests that several cardiovascular risk factors traditionally associated with cardiovascular disease may be associated with hearing loss; therefore, we conducted an umbrella review to synthesize existing systematic reviews and meta-analyses evaluating this association. Systematic reviews and meta-analyses were searched in PubMed, Scopus, Web of Science, and the Cochrane Library from inception to April 2025. Methodological quality was assessed using the AMSTAR-2, and the certainty of evidence was evaluated using the GRADE criteria. Ten systematic reviews were included. Associations were observed between hearing loss and multiple cardiovascular risk factors and comorbidities, with the most consistent evidence for cardiovascular disease, metabolic syndrome, hypertension, diabetes, obesity, smoking, and alcohol consumption; findings for total cholesterol and low-density lipoprotein cholesterol were inconsistent or not statistically significant. The reported odds ratios ranged from 0.78 to 4.22. These associations may be related to mechanisms such as microvascular damage and inflammation; however, the certainty of the evidence was generally low. Overall, the findings suggest a possible association between cardiovascular risk factors and hearing loss, although they highlight the need for further longitudinal studies with standardized hearing loss definitions and improved control of confounding factors.